Chapter 4

For the next month, Davud worked things out with his boss to pick up portable equipment like EKG’s, baby monitors, IV machines, etc., and repair them at home. This way, he could take care of Mina also. They had been married for about a month when Davud made an appointment at Johns Hopkins Hospital to determine if Mina’s hearing was permanent or could be partially or fully restored. They first ran a CT scan, but it proved inconclusive, so they did an MRI. It proved that Mina’s hearing was destroyed by trauma. Repeated hitting the head with the flat of the hand on the side of her head, thereby causing pressure and sound trauma due to the beating. The scarring showed that she’d been this way for over ten years. She was beaten as a child, presumably by her father. So, there was nothing to be done regarding Mina’s hearing.

They put these things on my ears, I wonder why? Are they trying to see if I can hear something? Maybe they are trying to find a way to make me hear again ... That would be wonderful!

The next step was determining if Mina’s sight could be restored. At Wilmer’s eye clinic at Hopkins, they took pictures of the inside and back of both of her eyes but found nothing wrong. Next, their work-up initially included magnetic resonance imaging (MRI) of the brain and eye orbits. When evaluating chiasmal, hypothalamic, and optic tract for tumors, MRI is superior to computed tomography (CT).

This is weird ... Lay down on a table that moves one way and back again. Why is that?

What they discovered where optic nerve benign glioma [tumors]. Davud was told that optic nerve gliomas comprise about 1% of all intracranial tumors. They are almost always unilateral and occur more frequently in females than in males. These tumors may occur at any age, but most become symptomatic in childhood.

Optic nerve gliomas are benign (non-cancerous) brain tumors that grow on the nerves that carry vision from the eyes to the brain (the optic nerves). These tumors commonly arise in young children and can affect their vision. Strangely, young children never complain about loss of vision, they just accept that it is. In addition to tumors that grow on the optic nerves, similar tumors in children may grow in a region of the brain called the hypothalamus.

The hypothalamus is a part of the brain that is responsible for making hormones that trigger puberty. These tumors generally affect males, but about 5% are female related. Girls that have hypothalamus tumors generally fail to enter puberty or have interrupted puberty. This can be reversed by tumor removal, except that height is almost always is permanently affected. This is the reason why Mina looked like a ten-year-old who had started puberty, but never finished.

What was very promising was that the MRI showed that the tumors were merely compressing and squeezing the optic nerves but had not invaded the nerves themselves.

They were certain that surgery was the proper treatment to correct her optic nerve compression. Endoscopic endonasal surgery is a minimally invasive technique that allows a surgeon to go through the nose and sinus cavities to operate on areas at the front of the brain and the top of the spine. A thin tube called an endoscope is threaded through the nose and sinuses. This gives the surgeon access to parts of your brain that would be hard to reach using traditional surgical approaches and often require large incisions and removal of parts of the skull.

The surgery, based on the MRI, will take about 4 to 6 hours to complete. They were confident they could remove all the tumors, including those attached to her hypothalamus. Following endoscopic endonasal surgery, Mina will spend on average of 2 to 5 days in the hospital. Immediately following surgery, they will tape her eyelids shut and bandage her eyes so that they can rest. After five days, they’ll remove the bandages and then learn how much, if any, of her sight she has recovered. Her vision may be blurry for up to a day or two, but it will clear up. After six weeks, they’ll have her vision tested for glasses if she needs them.

They scheduled the surgery for five days hence, Tuesday at 7:30am. She needs to be there at 6am to be prepped. Davud asked if he could be present during the surgery prep. She will have no idea what is going on and needs him there to keep her calm. And he definitely needs to be there in recovery when she awakens.

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The morning of the surgery, Davud got Mina up at 5am. She was half asleep as she tried to dress, but was so sleepy, Davud ended up helping her finish putting her shoes and socks and her coat on. It was mid-March and still cold outside. They arrived at the hospital at six sharp. Davud helped her get undressed and into the hospital gown. She was a little frightened when they put the IV in her hand, but Davud was able to keep her calm. They gave her a sedative and she was almost asleep when they wheeled her in for the surgery. Davud then picked a chair in the corner of the waiting room and decided to sleep for a while and wait for them to call him into the recovery room. A few minutes later, a nurse came out and told him that everything was well, the surgery started on time at 7:30 and she should be out sometime between 12 and 1pm. Davud thanked her and fell off to sleep in a chair.

David was playing a game on his phone when the nurse came to get him to go into the recovery room at 12:20. He was told when she woke up, to try and keep her calm and her hands away from the bandages. She’ll have gauze packed in each nostril and her eyes have been taped shut and bandaged. Davud told them that he would do his best to keep her calm.